Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1principles of anesthesia > Breathing Systems Pt. 3 (Exam 2) > Flashcards

Breathing Systems Pt. 3 (Exam 2) Flashcards

1
Q

What components are missing from a Mapleson circuit?

A
  • CO₂ absorber
  • Unidirectional valves
  • Separate Ins & Exp limbs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which system has the best efficiency for spontaneous ventilation?

A

Mapleson A (Magill’s System)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which system has the worst efficiency for controlled ventilation?

A

Mapleson A (Magill’s System)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rebreathing with a Mapleson A during a controlled ventilation situation occurs unless what?

A

Unless minute ventilation if very higher (>20 L/min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is rebreathing prevented during spontaneous ventilation with a Magill’s system?

A

FGF must be greater than (or equal to) minute volume.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the location of the FGF and APL valve in the mapleson A?

A
  • FGF near reservoir opposite end of pt
  • APL is near pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What breathing system is depicted?

A

Mapleson A (magill’s system)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

FGF should be 2x minute volume during spontaneous and controlled ventilation to prevent rebreathing in a _________ system.

A

Mapleson B

System is obsolete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the location of the FGF and APL valve in a mapleson B system?

A

both near the pt

Much of FGF is vented through APL during exhalation rendering it inefficient and obsolete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which breathing system is depicted?

A

Mapleson B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does a Mapleson C circuit differ from a Mapleson B?

A

Identical except Mapleson C excludes corrugated tubing found on Mapleson B.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What circuit is used for emergency resuscitation and is almost as efficient as a Mapleson A?

A

Mapleson C
-Similar to ambubag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What FGF is characterized in a Mapleson C circuit?

A

2x minute volume.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What breathing system is depicted?

A

Mapleson C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What breathing circuit is most efficient for controlled ventilation?

A

Mapleson D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the Bain modification?
What breathing circuit is it used on?

A

FGF coaxial inside tubing for inspiration. Expiratory gasses exhaled into surrounding corrugated tubing.

Used on a Mapleson D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What FGF is used with a Mapleson D system?

A

FGF 2 - 2.5 x minute ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the location of the APL valve and FGF inlet for a mapleson D?

A
  • APL near reservoir (at end, opposite pt)
  • FGF inlet near pt (unless bain mod)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which breathing system is depicted?

A

Mapleson D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which circuit has no reservoir bag or APL valve?

No capability to manually ventilate the patient

A

Mapleson E (Ayre’s T-piece)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which circuit is used in spontaneously breathing patients to deliver O₂ ?

A

Mapleson E (Ayre’s T-Piece)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is another name for a Mapleson E circuit?

A

Ayre’s T-Piece

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A Mapleson F (Jackson Rees) is a modified ___________ circuit, where a ___________ is added to the circuit.

A

A Mapleson F (Jackson Rees) is a modified mapleson E circuit, where a reservoir bag is added to the circuit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is excessive pressure prevented with a Mapleson F circuit?

A

No APL valve present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What FGF is used with a mapleson F (jackson rees)?

A

2 - 2.5x minute ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which mapleson systems allow for significant amounts of fresh gas to be vented through pop-off at end expiration?

A

BC systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which mapleson systems allow FGF to drive exhaled alveolar gas awar from the patient?

A

DFE systems

28
Q

List all the Mapleson Circuits in terms of most efficient to least efficient for spontaneous ventilation.

A

A > DFE > BC

29
Q

List all the Mapleson Circuits in terms of most efficient to least efficient for controlled ventilation.

A

DFE > BC > A

30
Q

What are the advantages of Mapleson Circuits? (4)

A
  • Simple, inexpensive, lightweight
  • Low resistance to gas flow
  • No toxic products d/t lack of CO₂ absorbent
  • No degradation of VA’s
31
Q

What are the disadvantages of Mapleson circuits? (4)

A
  • Require high FGF
  • Can’t conserve heat & humidity
  • Scavenging difficult (except D)
  • Not suitable for MH patients (cant increase FGF to remove CO₂)
32
Q

Identify the following

A
33
Q

Extent of rebreathing and conservation of exhaled gasses in a circle system depends on _____.

A

FGF

34
Q

In a circle system, higher FGF = less _________ and more ______ ____.

A

rebreathing; waste gas

35
Q

How is rebreathing prevented in a circle system?

A
  • Unidirectional valves located between patient & reservoir bag
  • FGF cannot enter circuit between exp valve & patient
  • APL valve cannot be located between patient & inspiratory valve.
36
Q

What characteristics define a semi-closed circle system?

A
  • Low-flow anesthesia
  • FGF < minute ventilation
  • 50% of expired gas is rebreathed after CO₂ removal
37
Q

What kind of rebreathing is present in a semi-closed circle system?

A

Partical rebreathing, but some waste flow is vented through APL or ventilator waste valve

38
Q

In what patients would a semi-open circle system be used?
Why?

A
  • post-op & ICU vents, scuba
  • Higher FGF w/ minimal rebreathing and more venting of waste gasses.
39
Q

What are the characteristics of a closed circle system? (5)

A
  • Complete rebreathing
  • No waste gas vented
  • O₂ inflow exactly matches metabolic demand
  • low/Minimal flow anesthesia
  • VAs are added in precise amounts

impractical for use

40
Q

What are the advantages of Low-flow anesthesia? (3)

A
  • Decreased VA usage
  • Better temp & humidity control
  • Reduced environmental pollution
41
Q

What are the disadvantages of low-flow anesthesia? (3)

A
  • Difficulty adjusting depth quickly
  • Possible accumulation of exhaled gases (CO, acetone, methane, etc)
  • VA degradation products (CO, Compound A)
42
Q

What are the advantages of a circle system? (5)

A
  • Low FGF can be used
  • CO₂ elimination
  • Conserves heat/moisture/etc.
  • OR pollution prevention
  • stable inspired gas concentration
43
Q

What are the disadvantages to a circle system? (3)

A
  • Complex design
  • CO or compound A
  • Compromised VT during controlled ventilation (distensible tubing)
44
Q

What are the use cases for self-inflating manual resuscitators? (4)

A
  • Pt transport
  • CPR
  • Emergency backup
  • hand ventilation in absence of O₂ or medical air
45
Q

What are hazards associated with self-inflating manual resuscitators? (4)

A
  • Barotrauma
  • Gastric insufflation
  • Large variation in VT, PIP, and PEEP
  • non-rebreathing valves generate resistance
46
Q

Where are bacterial filters placed on the breathing system?

A

Expiratory limb

47
Q

What are the two types of bacterial filters?

A
  • Small pore compact matrix (↑ resistance, pleated for ↑ surface area)
  • Large pore ( ↓ resistance, smaller surface area)
48
Q

Where would a combination bacterial filter (filter + HME) be placed?

A

At the Y-piece (inspiratory and expiratory barrier)

49
Q

Hydrophobic bacterial filters provide what characteristics? (3)

A
  • prevent water penetration
  • increases resistance
  • decreases efficiency
50
Q

What are some of the complications of bacterial filters? (2)

A
  • Obstruction (sputum, edema fluid, etc)
  • Leakage
51
Q

What are the following definitions?
Humidity:
Absolute humidity:
Relative humidity:
Water vapor Pressure:

A

Humidity: amount of water vapor in a gas
Absolute humidity: mass of water vapor in a gas (mgH₂O/L)
Relative humidity: Percent saturation of water vapor
Water vapor Pressure: pressure exerted by water vapor in a gas

52
Q

At what point in the airway is heating and humidification of air completed by?

A

Mid-Trachea

53
Q

Cool inspired gas may trigger ________.

A

Bronchospasm (poorly understood MOA)

54
Q

Max contact of inspired gas w/ large mucosal surface area in the _______?

A

Nasal cavity

55
Q

Absolute humidity of _____ mg/L is equal to 100% relative humidity.

A

44 mg/L

56
Q

Where would you find isothermic saturation boundary? At what temp?

A

Usually at the carina

37 ºC

57
Q

How do cold ambient temperatures affect humidity? (3)

A
  • little capacity to hold water vapor
  • low absolute humidity
  • upper airway transfers large amounts of heat and moisture
58
Q

What can occur with underhumidification of air? (3)

A
  • Resp Tract damage (secretions, poor ciliary function, impaired surfactant, dried mucosa)
  • Body heat loss
  • Tracheal tube obstruction (thickened secretions)
59
Q

What can occur with overhumidification of air? (4)

A
  • water intoxication
  • inefficient mucociliary transport
  • airway resistance
  • sensor obstruction
60
Q

What are HMEs?
Where are they placed?
How do they generally work?

A
  • Heat and Moisture Exchanger
  • Placed close to pt, between Y-piece and proximal end of ETT
  • conserve some exhaled heat/water and return it to pt
61
Q

What are some disadvantages with use of an HME?

A
  • Lower EtCO₂ reading
  • ↑ resistance & circuit dead space
  • Reduced efficiency w/ large VT
62
Q

What are hygroscopic HMEs? What do they do? What are they efficient at?

A
  • paper or fiber barrier coated material with moisture-retaining chemicals
  • absorb water in exhalation and release in inspiration
  • most efficient retaining heat/moisture
63
Q

What are hydrophobic HMEs? What are they efficient at?

A
  • pleated hydrophobic membranes with small pores
  • more efficient filters of pathogens
64
Q

Humidifiers can be heated or unheated, and placed where?

A
  • Placed in inspiratory limb downstream of unidirectional valve.
    should not be placed on expiratory limb
65
Q

What are the advantages of active humidifiers? (2)

A
  • Can deliver gas at body temp or even higher
  • More effective than HME’s
66
Q

What are the disadvantages of active humidifiers? (5)

A
  • Bulky
  • Contamination (hard to clean)
  • Expensive (compared to HME)
  • Electrical problems/ thermal injury potential
  • Water aspiration risk

1principles of anesthesia (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions